Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain Medicare Solutions Policy Summary

March 15, 2013
Rick Gawenda

From UnitedHealthcare March 2013 Network Bulletin

CMS issued National Coverage Determination (NCD) 160.27 Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low Back Pain (CLBP) effective June 8, 2012, limiting coverage of TENS for CLBP to members who are enrolled in a CMS approved clinical trial and meet certain criteria.

When coverage requirements are met original Medicare will be responsible for payment of TENS for CLBP under the clinical trial, NCD 310.1 Routine Costs in Clinical Trials. Otherwise, TENS for CLBP is not covered and UnitedHealthcare Medicare Advantage Plans will no longer be responsible for payment.

This applies to all members for service dates on or after June 8, 2012 who currently rent or want to purchase TENS units and associated supplies. For services on and after June 8, 0212, providers may submit relevant TENS claims to original Medicare for possible coverage and /or payment under the clinical trial NCD.

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